Prehospital Trauma Myths

Busting Trauma Myths…

  1. Nasopharyngeal airway placement can safely be performed in patients with a head injury when airway management is needed. The benefit of establishing an airway outweighs the incredibly small risk of the NPA entering the brain.
  2. Backboards (Spine boards) have no proven benefit for the trauma patient and can be harmful by compromising a patient’s ventilations, placing them at risk for pressure ulcers and delaying transport to definitive care. That being said, spinal motion restriction in trauma patients is good practice.
  3. The evidence demonstrates that not only does the Trendelenburg position not help patients experiencing hemorrhagic shock, but it can actually be harmful because of effects on both ventilatory and circulatory systems.
  4. The KED increases spinal column motion during the extrication process; alternative methods of extrication need to be considered and explored.
  5. If initial direct pressure fails to control haemorrhage, remove the dressing and apply well-aimed direct pressure onto the haemorrhage location. When this fails, a tourniquet or hemostatic agent should be used.
  6. Using the 80/70/60 rule for peripheral pulses overestimates a haemorrhaging patient’s blood pressure and may put them at risk for delayed intervention. Obtain accurate blood pressures. There is a key component of common sense here, though—if you cannot feel your patient’s radial pulse they are likely to be very hypotensive and ill.
  7. Delivery of patients suffering from a traumatic injury to a trauma centre within 60 minutes of their incident does not improve their outcomes unless they present in hemorrhagic shock. Safe transport to a trauma centre is more important than rapid transport.



Emergency Medicine Kenya Foundation